ROUTINE ENDOCRINE SCREENING FOR PATIENTS WITH KARYOTYPICALLY NORMAL SPONTANEOUS PREMATURE OVARIAN FAILURE

Objective: To evaluate the usefulness of routine screening for other a ssociated autoimmune endocrine disorders in patients with karyotypical ly normal spontaneous premature ovarian failure. Methods: One hundred nineteen women with karyotypically normal spontaneous premature ovaria n failure (FSH exceeding 40 mIU/mL) who desired fertility were evaluat ed at a tertiary care academic center by physical examination, measure ment of serum free thyroxine and TSH, ACTH stimulation test, fasting s erum glucose, 3-hour glucose tolerance test, measurement of serum elec trolytes including total calcium, and measurement of serum vitamin B-1 2. Results: Twenty-two of 119 patients (18.5%) were known to have hypo thyroidism and three were known to have Addison disease. Ten new cases of hypothyroidism and three new cases of diabetes mellitus were disco vered. However, no new cases of adrenal insufficiency, hypoparathyroid ism, or pernicious anemia were found. Conclusion: Screening for hypoth yroidism and diabetes appears justified in those patients with karyoty pically normal spontaneous premature ovarian failure who desire fertil ity. However, our findings suggest that in these patients, testing for other associated autoimmune endocrine disorders may be reserved for t hose with clinical indications. (C) 1997 by The American College of Ob stetricians and Gynecologists.